The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry
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Am J Geriatr Psychiatry · May 2006
Randomized Controlled TrialA responder analysis of memantine treatment in patients with Alzheimer disease maintained on donepezil.
The objective of this study was to examine the clinical utility of memantine for moderate-to-severe Alzheimer disease (AD) using responder analyses. ⋯ These responder analyses may assist clinicians in evaluating the impact of memantine in a relevant clinical scenario, i.e., in patients with AD previously stabilized on a cholinesterase inhibitor. The current results indicate that in this setting, memantine produces both improvement and stabilization of symptoms, across multiple outcomes, and thus provides a clinically important treatment benefit for patients with moderate-to-severe AD.
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Am J Geriatr Psychiatry · Mar 2006
Randomized Controlled Trial Comparative StudyDepressive symptom deterioration in a large primary care-based elderly cohort.
The purpose of this study is to examine the incidence and clinical predictors of symptom deterioration in depressed elderly patients who have responded to treatment in primary care. ⋯ There is a high rate of symptom deterioration among elderly patients in primary care who are treated for depression. Efforts to improve long-term outcomes of older patients with major depression and/or dysthymia should focus on providing more intensive treatment and follow up for patients with residual depressive symptoms.
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Am J Geriatr Psychiatry · Dec 2005
Randomized Controlled TrialDonepezil in the prevention and treatment of post-surgical delirium.
Delirium is a frequent complication of major surgery in older persons. The authors evaluated the possible benefit of donepezil versus placebo in the prevention and treatment of postoperative delirium in an older population without dementia undergoing elective total joint-replacement surgery. ⋯ This pilot study was unable to demonstrate a benefit for donepezil in preventing or treating delirium in a relatively young and cognitively-intact group of elderly patients undergoing elective orthopedic surgery. Furthermore, postoperative delirium was not a major problem in this population.
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Am J Geriatr Psychiatry · Nov 2005
Randomized Controlled Trial Multicenter StudyDivalproex sodium in nursing home residents with possible or probable Alzheimer Disease complicated by agitation: a randomized, controlled trial.
Three placebo-controlled clinical trials have suggested the benefit of valproate for treatment of agitation associated with dementia; one was used as the basis for this multicenter trial, conducted by the Alzheimer's Disease (AD) Cooperative Study. It addresses the efficacy, safety, and tolerability of divalproex sodium for the treatment of agitation associated with dementia. ⋯ This multicenter trial showed no benefit of divalproex sodium for treatment for agitation in dementia at a mean dose of 800 mg/day over 6 weeks. The results do not support findings from previous trials indicating possible benefit.
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Am J Geriatr Psychiatry · Jan 2005
Randomized Controlled Trial Clinical TrialImpact of comorbid panic and posttraumatic stress disorder on outcomes of collaborative care for late-life depression in primary care.
Comorbid anxiety disorders may result in worse depression treatment outcomes. The authors evaluated the effect of comorbid panic disorder and posttraumatic stress disorder (PTSD) on response to a collaborative-care intervention for late-life depression in primary care. ⋯ Collaborative care is more effective than usual care for depressed older adults with and without comorbid panic disorder and PTSD, although a sustained treatment response was slower to emerge for participants with PTSD. Intensive and prolonged follow-up may be needed for depressed older adults with comorbid PTSD.